Percent positive axillary lymph node metastasis predicts survival in patients with non-metastatic breast cancer
Percent positive axillary lymph node metastasis predicts survival in patients with non-metastatic breast cancer
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DOI：
10.1080/02841860701678761
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发表时间：
2008-01-01
期刊：
影响因子：
3.1
通讯作者：
Hayran, Mutlu
中科院分区：
文献类型：
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作者：
Atahan, Ibtisam Lale;Yildiz, Ferah;Hayran, Mutlu
目的。我们回顾性评估了腋窝淋巴结受累阳性百分比对接受乳房切除术后放疗和化疗的非转移性乳腺癌患者治疗结果的影响。材料和方法。 1994年1月至2002年12月期间，对939名符合条件的非转移性乳腺癌患者的医疗记录进行了分析。如果手术切缘阳性、肿瘤大小等于或大于4厘米、皮肤筋膜侵犯，则需要进行胸壁放射治疗。腋窝淋巴结转移超过3个、腋窝淋巴结清扫不完全（<10个淋巴结）、囊外扩展或淋巴结周围脂肪组织侵犯时，应进行淋巴照射。胸壁和淋巴结区域的总剂量为 50 Gy，每日剂量为 2 Gy。通过Kaplan-Meier法、Log-rank检验和Cox回归分析进行统计分析。结果。所有存活患者的中位随访时间为 62 个月。整个队列的 5 年总生存率 (OS) 和无病生存率 (DFS) 分别为 81% 和 65%。 OS 的单变量分析揭示了肿瘤大小（5cm，p < 0.001）、转移淋巴结受累（0 vs. 1-3 vs. >4 LN，p）的显着性
Purpose. We retrospectively evaluated the impact of percent positive axillary nodal involvement on the therapeutic outcomes in patients with non-metastatic breast cancer receiving postmastectomy radiotherapy and chemotherapy. Materials and methods. Between January 1994 and December 2002, the medical records of 939 eligible non metastatic breast carcinoma patients were analyzed. Chest wall radiotherapy was indicated in case of positive surgical margin, tumor size equal or more than 4 cm, skin-fascia invasion. Lymphatic irradiation was applied for more than three metastatic axillary lymph nodes, incomplete axillary dissection (< 10 lymph nodes), extracapsular extension or perinodal fat tissue invasion. A total dose of 50 Gy was given to chest wall and lymph node regions with 2 Gy daily fractions. Statistical analyses were performed by Kaplan-Meier method, Log-rank test and Cox's regression analysis. Results. The median follow-up for all patients alive was 62 months. The 5-year overall survival (OS) and disease-free survival (DFS) for entire cohort were 81%, and 65%, respectively. Univariate analysis for OS revealed significance for tumour size ( 5cm, p < 0.001), metastatic nodal involvement (0 vs. 1-3 vs. >4 LN, p